Serum leptin levels after bariatric surgery across a range of glucose tolerance from normal to diabetes.

BACKGROUND: A longitudinal, clinical intervention study with bariatric surgery was done to investigate the relationship between leptin levels, BMI, and insulin during weight loss across a range of glucose tolerance from normal to diabetes. METHODS: 43 morbidly obese patients (BMI: 42-75 kg/m2) undergoing vertical banded gastroplasty Roux-en-Y gastric bypass (VBG-RGB), were divided into 3 groups: 21 normal (NGT), 12 impaired glucose tolerance (IGT) and 10 type 2 diabetes (DM). Leptin, insulin, glucose, lipids and uric acid were measured at baseline and 2, 4, 6, and 12 months following surgery. RESULTS: BMI fell from 54.1 +/- 9.1 to 34.6 +/- 6.3 kg/m2, similarly in all groups. Leptin decreased from 73.9 +/- 8.7 to 16.9 +/- 10.2 ng/ml and was strongly correlated with BMI during 1-year follow-up (r = 0.78; p < 0.001). Linear univariate analysis for repeated evaluation showed a positive correlation between leptin and glucose, triglycerides, uric acid, and insulin. Multivariate regression analysis indicated that BMI was independently correlated with the decrease in leptin (p < 0.001), accounting for 66% of the variance in leptin levels during weight loss. These results were found in the NGT and IGT groups. In the DM group, a small additional influence in leptin levels was attributed to glucose decrease. CONCLUSIONS: A strong link between leptin and BMI was found after surgery. BMI was the main determinant of the decrease of leptin. In these patients submitted to bariatric surgery, ranging from normal glucose tolerance to diabetes, changes in insulin levels and metabolic parameters, except for glucose in the DM group, did not appear to be correlated with changes in leptin levels.

Introducao ao estudo da sexualidade feminina. / Introduction to the study of female sexuality

A presente monografia tem como objetivo propor uma reflexao, a partir de uma experiencia vivida por nos durante um ano de atendimento no ambulatorio do Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, sobre a forma com que a mulher vivencia sua sexualidade, assumindo um papel na sociedade, nem sempre determinado por ela propria. Para tal, descrevemos os pontos de vista da biologia, da psicologia e da historia que tentam explicar a identidade feminina. Dentro dessas abordagens, ressaltaremos como a mulher sempre foi vista em funcao do homem. A parte final do trabalho tratara da apresentacao e analise de fragmentos de casos clinicos relacionado a dinamica da sexualidade feminina. Na conclusao, propomos uma discussao nao so acerca do papel da mulher dentro da sociedade, como tambem da relatividade da dependencia existente entre os papeis feminino e masculino